Please check one: Applicant s Legal Business Name: Phone # ( ) Credit Requested$

Transcription

1 Please check one: New Update Credit Limit Increase (Inactive) CREDIT APPLICATION Applicant s Legal Business Name: Phone # ( ) D/B/A (if different than above) Fax #( ) Address Cell # ( ) Credit Requested$ Shipping Address: (Street) (City) (State) (Zip) Years at this Address County Business Building is Owned Rented OWNERSHIP: Sole Owner Partnership Corporation Other Specify: Type of Business Date Established and/or Incorporated State of Incorporation IF INCORPORATED PLEASE PROVIDE FEDERAL EIN NUMBER IF SOLE OWNER OR PARTNERSHIP, PLEASE PROVIDE COPY OF DRIVERS LICENSE FOR OUR RECORDS Is your Business Taxable? Yes No If not, please supply a resale certificate. Contact Name Title Contact (Sales) Contact (A/P) Annual Sales Net Worth TRADE REFERENCES: NAME ADDRESS PHONE & FAX NUMBERS FINANCIAL STATEMENT ENCLOSED YES NO Has your company or any of the principals ever filed for bankruptcy? YES NO Have you or your company ever had judgments or liens placed against you? YES NO If yes, please detail status. Willow Grove, PA York, PA Olyphant, PA Edison, NJ Herndon, VA New Castle, DE (215) (717) (570) (732) (703) (302) Fax: (215) Fax: (717) Fax: (570) Fax: (732) Fax (703) Fax: (302)

2 AGREEMENT TO TERMS OUR TERMS ARE 1% 10 NET 30 DAYS FIRM, UNLESS OTHERWISE STATED. I hereby attest that all information included on this credit application is true and accurate. We authorize Derr Flooring Company to run any credit inquiries and / or credit reports they deem necessary for their evaluations. The applicant will be responsible for the payment of all invoices and agrees to Derr s return policy; which is: 25% Restocking Charge on material we pick up, 15% Restocking Charge on material you return. Only full unopened packages or cartons of merchandise accepted within 30 days of the original invoice no exception shall be made to this policy. There may be a service charge of 1 ½ % per month for past due balances (18%) per year. In the event that Derr Flooring Co. has to file suit against the undersigned to enforce this agreement, it is understood & agreed to by all parties that suit may be filed & venue may be in Montgomery County, PA. It is further agreed; all costs for this action will be assumed by the debtor. I/WE agree to pay all indebtedness in accordance with these terms. Financial responsibility for this account will remain in effect until written notice stating a change is received and confirmed by Derr Flooring Co. X X (Signature) (Date) (Signature) (Date) (Print Name) (Officer/Owner) (Print Name) (Officer/Owner) I, as Corporate Officer or Owner of Applicant above in consideration of credit being extended by Derr Flooring and intending to be legally bound, do hereby personally, jointly and severally guarantee all debts and obligations of Applicant to Derr Flooring and all renewals and extensions thereof. This guarantee will be interpreted under laws of the Commonwealth of Pennsylvania. By signature we grant Derr Flooring Co. the right to check all facts pertinent to the fair evaluation of establishing credit with said corporation. In the event that Derr Flooring Co. has to file suit against the undersigned to enforce this agreement, it is understood and agreed to by all parties that suit will be filed and venue may be in Montgomery County, PA. It is further agreed; all costs for this action will be assumed by the debtor. X X (Signature) (Date) (Signature) (Date) (Address) (Address) ****************************BANK REFERENCE****************************** Checking Savings Loan Bank Name Phone # Contact Fax # Date Opened Average Balance Returned Items YES NO Reference given by Print Name & Title Date *****In anticipation of a FCC ruling requiring written permission to transmit faxed sales information; we request that you sign below to give said authorization to Derr Flooring Co.***** X Authorized Signature Date Print Name and Title

3 Page #1 TERMS OF SALE December 2014 HAVING POSSESSION OF OUR CATALOG DOES NOT CONSTITUTE AN OFFER TO SELL. EACH CUSTOMER MUST BE APPROVED PRIOR TO SALE. ALL MATERIALS LISTED ARE SUBJECT TO PRIOR SALE. ALL PRICES ARE SUBJECT TO CHANGE WITHOUT PRIOR NOTICE. MATERIAL IS SHIPPED AT MARKET PRICES PREVAILING AT TIME OF SHIPMENT, UNLESS OTHERWISE AGREED. TERMS OF PAYMENT PAYMENT TERMS AND METHOD ARE AT THE DISCRETION OF MANAGEMENT TERMS VARY BY PRODUCT REFER TO PRICE SHEET UNLESS OTHERWISE SPECIFIED TERMS ARE 1% 10 NET 30 DAYS CREDIT CARD PAYMENTS ARE NOT SUBJECT TO DISCOUNT DERR FLOORING CO. RESERVES THE RIGHT TO REVIEW CHANGE OR REMOVE CREDIT LINES AT OUR DISCRETION. CLAIMS AND RETURNS MATERIAL CLAIMS MUST BE MADE WITHIN TEN (10) DAYS AFTER RECEIPT OF SHIPMENT BY CONTACTING YOUR SALES REP OR CUSTOMER SERVICE REP. MATERIAL RETURNS MUST BE MADE WITHIN 30 DAYS OF THE INVOICE DATE. A RETURN MATERIAL AUTHORIZATION MUST BE ISSUED BY DERR PRIOR TO THE RETURN. (CONTACT YOUR DERR LOCATION) CREDIT WILL BE ISSUED AFTER THE MATERIAL IS INSPECTED AND APPROVED FOR RETURN BY DERR FLOORING. A RESTOCKING CHARGE WILL APPLY TO ALL GOODS RETURNED IN GOOD CONDITION. SHORTAGES AND DAMAGED MATERIAL IT IS THE RESPONSIBILITY OF THE BUYER TO INSPECT ALL DELIVERIES AND RECORD ON THE FREIGHT BILL ANY DAMAGE OR SHORTAGES. IT IS THE RESPONSIBILITY OF THE BUYER TO REQUEST INSPECTIONS AND FILE ANY CLAIM WITH THE CARRIER WITHIN THE CARRIER S STIPULATED TIME LIMITATIONS. **SPECIAL ORDER MATERIAL** A 50% DEPOSIT IS REQUIRED FOR SPECIAL ORDER MATERIAL TO BE ORDERED WITH THE MANUFACTURER A SIGNED CONFIRMATION IS ALSO REQUIRED TO PLACE THE ORDER. THE DOCUMENT STATES THAT THE MATERIAL CANNOT BE RETURNED OR CANCELLED, ONCE THE ORDER IS IN PROCESS. SPECIAL ORDER TERMS ARE NET UNLESS OTHERWISE STATED LIMITATION OF WARRANTY THERE IS NO WARRANTY, EXPRESS OR IMPLIED ON THE GOODS COVERED BY THIS AGREEMENT AND ALL SUCH WARRANTIES INCLUDING WITHOUT LIMITATION ANY IMPLIED WARRANTY OF MERCHANTABILITY OR FITNESS FOR A PARTICULAR PURPOSE ARE HEREBY EXCLUDED. SELLER NEITHER ASSUMES NOR AUTHORIZES ANY OTHER PERSON TO ASSUME FOR IT ANY OTHER OBLIGATION OR LIABILITY IN CONNECTION WITH THE GOODS SOLD. SPECIAL PRICES, PROGRAMS AND DISCOUNTS SPECIALS ARE ONLY AVAILABLE TO CUSTOMERS IN GOOD CREDIT STANDING! SPECIALS APPEAR IN THE QUARTERLY CHRONICLE & ON OUR WEBSITE By placing my signature below I indicate my understanding and agreement to be legally bound to all the terms of sale listed. Signature Date

4 Page #2 TERMS OF SALE LIMITATION OF REMEDY THE SELLER ASSUMES NO LIABILITY OR RESPONSIBILITY FOR ANY LOSS OR DAMAGE, WHETHER DIRECT, INDIRECT, OR CONSEQUENTIAL, ARISING FROM OR ALLEGED TO HAVE ARISEN FROM THE USE OF OR FAILURE TO DELIVER, OR LATE OR DELAYED DELIVERY OF ANY OF THE GOODS. ALL GOODS ARE SUPPLIED BY SELLER ON THE EXPRESS TERMS THAT UNDER NO CIRCUMSTANCES WILL SELLER BE HELD LIABLE FOR ANY INJURY TO ANY PERSON OR PERSONS WHICH MAY BE ATTRIBUTED OR ALLEGED TO HAVE ATTRIBUTED TO THE USE OF ANY GOODS WHICH MAY HAVE BEEN MANUFACTURED, CONSTRUCTED, TREATED, SOLD, SUPPLIED OR DISTRIBUTED BY THE SELLER. BUYER AGREES TO INDEMNIFY AND HOLD SELLER HARMLESS AGAINST ANY CLAIMS WHICH MAY BE RAISED AGAINST THE SELLER BY THE ULTIMATE USERS OF ANY OF THE GOODS AND BUYER HEREBY ACCEPTS AND ACKNOWLEDGES RESPONSIBILITY FOR ANY LOSS OR DAMAGE CAUSED BY THE GOODS OR ANY PRODUCT INTO WHICH THE GOODS ARE INCORPORATED. COMPLAINT PROCEDURES THE DEALER OR DEALER S SALES PERSON MUST FIRST INSPECT THE JOB TO DETERMINE WHAT THE PROBLEM IS: INSTALLATION, JOB CONDITION OR MANUFACTURING RELATED. HISTORICALLY ALMOST ALL FLOORING COMPLAINTS ARE A RESULT OF UNFAVORABLE JOB CONDITIONS OR SUB-STANDARD INSTALLATION. TO TAKE A COMPLAINT TO THE NEXT STEP, IT WILL BE NECESSARY FOR THE DEALER TO FILL OUT OUR STANDARD COMPLAINT FORM AND OBTAIN SAMPLES OF THE AFFECTED AREA IF POSSIBLE. DERR FLOORING CO NEITHER MANUFACTURES NOR INSTALLS PRODUCTS. ALL WARRANTIES ORIGINATE AND ARE HELD BY EITHER THE MANUFACTURER OR INSTALLER. PLEASE REFER TO THE WARRANTY INFORMATION WHICH ACCOMPANIED YOUR MATERIAL. TAXES SALES TAX WILL BE CHARGED BY THE SELLER TO THE BUYER ON ALL MATERIAL SOLD IN STATES WHERE DERR FLOORING CO IS LICENSED TO DO BUSINESS. IF THE BUYER IS LICENSED FOR RESALE, A VALID CERTIFICATE MUST BE ON FILE AT DERR FLOORING CO. IF FOR ANY REASON IT IS DEEMED THAT SALES TAX IS DUE ON A PARTICULAR SALE THE BURDEN IS ON THE BUYER ONLY. FOR SALES OUTSIDE OUR DEFINED AREA THE BUYER IS RESPONSIBLE TO PAY ALL APPLICABLE SALES TAX. DUE TO THE MANY STATES THAT DERR FLOORING IS LICENSED TO COLLECT SALES TAX: WE RECOMMEND THAT IF YOU ARE DOING BUSINESS OUTSIDE YOUR HOME STATE THAT YOU CALL OUR CORPORATE CREDIT DEPT. (215) REGARDING YOUR POTENTIAL TAX OBLIGATION. DELIVERY PRICES DELIVERY CHARGES ARE SUBJECT TO CHANGE DUE TO ECONOMIC CONDITIONS, CALL YOUR BRANCH FOR PRICES. RETURNED CHECKS CHECKS RETURNED BY THE MAKER S BANK UNPAID WILL BE CHARGED A SERVICE FEE OF $50.00 IN ADDITION TO THE VALUE OF THE CHECK. FAILURE TO MAKE IMMEDIATE RESTITUTION WILL RESULT IN LEGAL OR CRIMINAL ACTION, OR BOTH AS DICTATED BY THE LAWS OF THE COMMONWEALTH OF PENNSYLVANIA. ALL ACCOUNTS SUBJECT TO A 1-1/2% MONTHLY SERVICE CHARGE AFTER 30 DAYS. By placing my signature below I indicate my understanding and agreement to be legally bound to all the terms of sale listed. Signature Date PLEASE SIGN & RETURN BOTH PAGES WITH YOUR COMPLETED CREDIT APP Willow Grove, PA York, PA Olyphant, PA Edison, NJ Herndon, VA New Castle, DE (215) (717) (570) (732) (703) (302) Fax: (215) Fax: (717) Fax: (570) Fax: (732) Fax (703) Fax: (302)

5 Derr Flooring Co fax Please choose three references from the list below: ALL COUNTY ALLSTATE ARLEY CLASSIC CMH ELIAS WILF FISHMAN MICHAEL HALEBIAN LONG NORMAN LIFTON PATRIOT SALESMASTER STANLEY STEPHENS TASK FLOORS GARDNER